Provider Demographics
NPI:1568045615
Name:AMA ANYWHERE
Entity Type:Organization
Organization Name:AMA ANYWHERE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-215-9531
Mailing Address - Street 1:3333 RENAISSANCE BLVD STE 223
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7008
Mailing Address - Country:US
Mailing Address - Phone:305-215-9531
Mailing Address - Fax:
Practice Address - Street 1:3333 RENAISSANCE BLVD STE 223
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7008
Practice Address - Country:US
Practice Address - Phone:305-215-9531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase Management